不稳定型锁骨远端骨折缝合锚固定术后的康复治疗

关键词：锁骨远端骨折  不稳定型骨折  肩  康复

Keywords:distal clavicle fracture  unstable fractures  shoulder  rehabilitation

摘要：

      目的：研究不稳定型锁骨远端骨折缝合锚固定术后系统肩关节功能训练的方法，并通过临床病例随访分析其疗效。方法：不稳定锁骨远端骨折缝合锚固钉术后患者68例。在康复治疗前、后及治疗期间，详细评测了肩关节ROM的变化，并采用GEPI方法对评测结果进行肩关节定量评定。康复治疗程序分为三个阶段，各阶段训练内容和侧重点根据病情的改善而不同。结果：术后12周时，患侧主动ROM接近正常，患侧GEPI平均为5.7%±2.06%；与患侧术后7周比较，有非常显著性差异（P<0.01）。平均随访31个月，68例患者的骨折愈合和功能恢复良好，患者均恢复以前的日常生活活动和运动水平，获得满意的结果。结论：不稳定型锁骨远端骨折应用缝合锚固定术后个性化、系统的肩关节功能训练方法是一种恢复肩关节功能的有效方法。

Abstract:

      Objective：To study the method and effectiveness of rehabilitation treatment after the operation of unstable distal clavicle fractures using suture anchor fixation. Method：A sample of 68 cases after the operation of unstable distal clavicle fractures using suture anchor fixation were involved in this study in the Department of Rehabilitation in Jishuitan Hospital, dating from March 2001 to December 2006. Comprehensive assessments of patients shoulder conditions were implemented before, during and after rehabilitation treatment, with detailed recording of ROM changes of involved shoulder joint. The subsequent results were measured in accordance with GEPI method. The rehabilitation treatment include three phases, in each phase training therapies were used in proper sequence according with the alleviation of their conditions. Result：On the 12th week, AROM of the involved shoulder approached normal level, with an average GEPI of 5.7%±2.06%. In comparison to the result at 7th week, the improvement was of much significance(P<0.01). At the end of average follow-up period of 31 months, all 68 cases had good fracture union and functional restoration; patients returned to previous life and activity level with satisfaction.Conclusion：Customized and systematic shoulder rehabilitation training for the unstable distal clavicle fractures using suture anchor fixation is an effective method to restore shoulder joint function.